[Ovarian remnant syndrome]. / Syndrom ovariálního zbytku.

OBJECTIVE: We report a case of the patient who 4 years after bilateral salpingo-oophorectomy had adenocarcinoma of ovary. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, Pardubická krajská nemocnice, a.s., Pardubice. SUBJECT AND METHOD: A case report of the patient diagnosed and treated at our department. CONCLUSION: The risk of ovarian remnant after operation is complication that is frequently related to a history of endometriosis, PID and multiple pelvic surgery. These complication is called ovarian remnant syndrome. Also an ovarian adenocarcinoma can develop in ovarian remnant. Effective therapy of ovarian remnant may usually be achieved by an operation demanding a wide approach to retroperitoneum.

Lysophosphatidic acid: an ovarian cancer marker.

OBJECTIVE: To determine whether lysophosphatidic acid (LPA) can serve as an ovarian cancer marker, we compared plasma LPA levels in ovarian cancer patients, in women with no ovarian pathology, and in women with benign ovarian tumors. We determined the optimal plasma LPA level cutoff value and correlated clinicopathological parameters with plasma LPA levels. METHOD: Capillary electrophoresis with indirect ultraviolet detection was used to analyze the plasma LPA levels of 133 patients (60 patients with ovarian cancer, 43 women without ovarian pathologies and 30 patients with benign ovarian tumors) during a three-year period. RESULTS: Patients with ovarian cancer had a significantly higher plasma LPA level (n=60, median (med) 16.99 micromnol/l, range 4.53-43.21 micromol/l) compared with controls with no ovarian pathology (n=43, med 2.92 micromol/l, range 0.94-22.93 micromnol/l) and patients with benign ovarian tumor (n=30, med 7.73 micromol/l, range 1.12-28.84 micromol/l) (p < 0.001). We found that plasma LPA levels were associated with the International Federation of Gynecology and Obstetrics (FIGO) stage and ovarian cancer histological type. Patients with endometrial ovarian cancer had significantly higher plasma LPA levels in comparison with other histological types of epithelial ovarian carcinoma. CONCLUSION: The plasma LPA level can be a useful marker for ovarian cancer, particularly in the early stages of disease.

[Lysophosphatidic acid in ovarian cancer patients]. / Lysofosfatidová kyselina u pacientek s karcinomem ovaria.

OBJECTIVE: To compare plasma lysophosphatidic acid (LPA) level in ovarian cancer patients and women without ovarian pathology. DESIGN: Prospective study. SETTING: Department of Gynecology and Obstetrics, University Hospital, Hradec Králové. METHODS: The method for LPA level analyze with its specification by capillary electrophoresis using indirect ultraviolet detection has been implementated. Since the beginning of this project venous blood samples from 103 patients (60 patients with ovarian cancer, 43 patients without ovarian pathology) have been obtained. RESULTS: Plasma LPA levels were elevated in ovarian cancer patients (sigma LPA Med 19.9 micromol/l, Range 4.5-42.7 micromol/l). Patients without ovarian pathology (n=35) (sigma LPA Med 2.6 micromol/l, Range 0.9-22.9 micromol/l, P<0,001) had statistically significant lower plasma LPA level compared with ovarian cancer patients. CONCLUSION: Lysophosphatidic acid appears useful as diagnostic marker of ovarian cancer.

[Results of conservative surgery of uterine fibroids--5 years of follow-up]. / Výsledky konzervativních operací delozních myomu. Petileté sledování.

OBJECTIVE: To evaluate the outcome of the myomectomy. DESIGN: Prospective study. SETTING: Gynecology-Obstetrics Ward, Regional Hospital Pardubice. METHODS: The group consists of 147 patients with uterine fibroid (or fibroids) in which was performed myomectomy from September 1997 till December 2001. Myomectomy was performed by hysteroscopy, laparoscopy, laparotomy or by posterior colpotomy. The mean age was 40.1 years. We evaluated short term (during the first year) and long term (after 5 years) outcomes including the pregnancy outcome. SHORT TERM OUTCOMES: During the 1st year 135 (91.84%) patients were without complications and satisfied with their status after the procedure. LONG TERM OUTCOMES: After 5 years 121 (82.31%) patients were without problems or reoperation. From the group of the women with the desire of the pregnancy the pregnancy rate was 71.05%. Deliveries of the viabile foetus were 77.78%. 38.10% delivieries were performed by Caesarian Section. CONCLUSION: At present it is often necessary to treat uterine fibroids without hysterectomy. We have several surgical approaches including the minimally invasive techniques that may be succesfull and the results may be satisfactory for most of the patients.

[Results of transcervical surgical therapy on endometrium polyps]. / Výsledky transcervikální chirurgické lécby polypu endometria.

OBJECTIVE: To evaluate short-term and long-term outcomes of the transcervical hysteroscopic ablation of endometrial polyps. DESIGN: A prospective clinical study. SETTING: Gynecology-Obstetrics Ward, Regional Hospital, Pardubice. METHODS: The study included 283 patients in whom in the period of September 1997 to June 1999 hysteroscopic ablations of the endometrial polyp were performed. The mean age of the collection was 58.3 years. 78.2% operations were performed as an outpatient procedure. We evaluated short-term outcomes, longterm outcomes and complications 5 years after the procedure. The patients were examinated by vaginal ultrasound 6 months after operation and then repeatedly in 12 months intervales. SHORT-TERM OUTCOME: There were performed 283 hysteroscopic ablations of the endometrial polyp in the period from September 1997 to June 1999. In one case (0.35%) the operation was complicated by uterine perforation without necessity of any intervention, in 6 cases (2.12%) the procedure was finished in the second session. In 3 patients (1.06%) the endometrial polyp showed malignant transformation. Long-term outcome: In 252 cases (89.05%) we did not notice any long-term complication. In the other cases (10.95%) the endometrial pathology was found by the vaginal sonography and it was necessary to perform other intervention. In 2 cases (0.71%) endometrial cancer was found. CONCLUSION: Hysteroscopic ablation of the endometrial polyp is at present fully indicated method for treatment of this pathology. The follow up by vaginal sonography is an elementary condition for the early diagnosis of the long-term complications.

[The management of uterine fibroids: Czech and Slovak Gynecologic Endoscopy Working Group (CSGE) clinical practice guidelines]. / Management delozních myomu: CSGE doporucení k provádení spráivné klinické praxe.

OBJECTIVE: The objective of this paper is to give a guideline to the management of uterine fibroids. DESIGN: Review. SETTING: Czech Society Gynecological Endoscopic Working Group. MATERIAL AND METHOD: The bibliographic data from Medline were reviewed from 2003-2004 using the key words: fibroid--leiomyoma--uterine artery occlusion--hysterectomy--myomectomy. CONCLUSION: The clinical guideline was prepared after the analysed data were supplied using the material and criteria of Society of Obstetricians and Gynaecologists of Canada (SOGC) for the management of uterine fibroids.

[HELLP syndrome in a female patient with multiple pregnancy in 36th week of gravidity--difficulties in diagnosis]. / HELLP syndrom u pacientky s vícecetným tehotenstvím ve 36. týdnu gravidity--úskalí diagnostiky.

OBJECTIVE: To present the case report on a very serious life-threatening condition. SETTING: Gynecology-Obstetrics Ward, Regional Hospital, Pardubice. CASE REPORT: HELLP syndrome with the development of DIC and hepatorenal failure in primigravida after IVF with multiple pregnancy.

[Serum lipid and lipoprotein levels in children in relation to their dietary habits and parental blood cholesterol]. / Hladiny sérových lipidu a lipoproteinu u detí ve vztahu k jejich nutricním návykum a k cholesterolémii rodicu.

In a group of 2000 Prague children aged 11-12 years the distribution of serum cholesterol levels was assessed. For further investigations 100 children with cholesterol levels above the 95th percentile (HYPER) were selected and 100 children with values between the 5th and 10th percentile (HYPO). Children and parents were subjected to detailed clinical and laboratory examination, in children the three-day dietary intake was assessed. Boys of the HYPER group had significantly higher LDL, HDL and VLDL cholesterol levels as well as levels of apolipoprotein B and less favourable values of the atherogenic index (AI). Girls of the HYPER group had significantly higher mean values of LDL-cholesterol and apolipoprotein B and also less favourable values of the AI. In the group HYPER children no abnormalities were detected in the carbohydrate metabolism nor a higher incidence of obesity although they differed significantly from children in the HYPO group as regards parameters of the lipid spectrum. The energy value of the consumed diet of children in the HYPER and HYPO group does not differ significantly. Although in boys of the HYPER group there was a higher ratio of total fat and animal fat (p less than 0.05), neither the percentage ratio of fatty acids nor the P:S ratio differed significantly in children of the HYPER and HYPO group. Parents of children of the HYPER group had significantly higher mean cholesterol, apolipoprotein B, LDL cholesterol values and less favourable values of the atherogenic index than parents of children of the HYPO group. The incidence of hypercholesterolaemia in the families of these children was also significantly higher.

[The medical and vaccination card for children--a document for the promotion of primary preventive care in pediatrics]. / Zdravotní a ockovací prukaz dítete--dokument k podpore primárne preventivních opatrení v pediatrii.

The basis of a comprehensive approach to prevention of chronic diseases of childhood is a system of uniform preventive examinations which makes it possible to examine the child in the parent's presence. This system accentuates the systematic training of parents with the aim to promote health and prevent the development of chronic disease. Part of the effort to improve the health consciousness of parents is the newly developed document, the child's health and vaccination card. This card--contrary to the basic documentation of the child--is his property and is kept by his parents at home. The card provides the parents as well as class teacher with basic information on the child's health status. This information must be used by the parents and teachers for primary preventive regime provisions. By issuing these cards to all children it will be possible to do away with examinations, necessary so far, in conjunction with issuing of certificates on the child's health status before major sports contents. This will reduce the unproductive administrative work of health community doctors and health community paediatric nurses and will save the time of parents who accompanied the children attending these examinations.